P Is Back In Therapy: Goals for Therapy

July 30, 2012

As I mentioned in the previous post, I started therapy again three weeks ago. I’m seeing her on Wednesdays. This Wednesday will be my fourth session.

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The second session I had with Brunet Young was just as productive as the first, but the third surprised me. Did I actually say all that? Yes, yes you did P. At ‘a girl!

It’s a good thing when you know what you’re getting yourself into when starting therapy. The same could not be said when I first went to see a counselor after my monumental mental meltdown in 2008. I had no idea what to expect then; I even walked out, or rolled out, of a therapist’s office in frustration in 2009. But this time… I have goals this time!

I came into therapy just as desperate, but more ready than ever. I know my borderline personality disorder (BPD) diagnosis, I’m more sure of the bipolar tendencies if the psychiatrist is right, and I’ve learned some basic dialectical behavioral skills training from Ex-Young Therapist as well as core training in cognitive behavioral therapy (CBT).

I’m barely driving out of hell, but I have a tank full of gas, me thinks. That’s hope for ya.

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On the second session, much like the first, we went over major areas of my life that need working on. I asked Brunet Young if she could tell me what it was she remembered about my history from the consultation team so I could fill in the rest as best I could.

I told her things like, “the overdose from two months ago was not my first, but definitely the worst” and “I have a history of abuse, though my views on it change. I mean, you have to understand our culture is different. But, it’s a fine line no?” I told her about my mother’s past suicidal tendencies, her upbringing, her sister’s (my aunt’s) suicide and so on. She already knew about my immigration situation, my medical problems, my tendency toward isolation, and my body image issues, so I didn’t have to go into that with her.

We talked a lot about how Monkey Man’s recent and sudden death has affected me, how I was drugged up with him much of the time we were together (off and on), but how I always tried to get him to stop drinking. We discussed ways in which I can work up my courage to call his step-mom and/or dad to ask about the toxicology report results again.

On and on we went. I couldn’t believe myself.

Towards the end of the session, she did something I was so thankful for. She asked me to write a list of issues I thought I hadn’t had a chance to go over with Ex-Young Therapist.

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My dad had taken me that second day and, on the way out, he said something that bothered me a little.

“She’s not good like the Ex-Young Therapist is she?”

“Why?” I asked.

“Well, she didn’t say hi to me as kindly as the other one.”

After the initial frustration this remark induced, a light bulb lit up in my head! Aha! I have to discuss this with Brunet Young, not this in particular, but my dad. I have to discuss how I think some of my black and white thinking patterns about myself lead back to his black and white thinking. I didn’t get into depth discussing my dad much with Ex-Young Therapist. I did a little, but more toward the end, or just when issues arose. In fact, because we focused so much on me learning DBT skills, the therapy process and focus remained on present problems and not past, “unresolved” problems.

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Last Wednesday, I decided to take the bus for our third session. It was better for all of us. My dad didn’t have gas money and I wanted the liberty of no off-handed comments.

It was an hour and a half bus ride; I have to take two buses and the MetroRail downtown but that’s a hell of a lot better than waiting on ole MetroLift’s shifty ass.

I arrived on time and with my homework assignment completed.

Here is my list of “past problems” I didn’t get to discuss with Ex-Young Therapist. And I added a bonus for Brunet Young. I added some therapy goals–totally my idea.

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I’m on a roll. I’m telling you. Here’s what I wrote down for her:

Goals for Therapy

*Manage Panic attacks and chronic pain

*Reduce suicidal and self-injurious impulses/actions/urges and manage the thoughts better. (No more overdosing!)

*Increase support network
-> continue rebuilding relationship with brother
-> get into that DBT group at BT (keep calling! don’t desist!)
-> get involved again in community organizing/activist orgs.

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* Interpersonal effectiveness -> review
* Distress tolerance -> review and continue practice!
* Develope a more consistent daily ruitine to include: writing/blogging, sketching, watching Lynda.com tutorials, planing, swimming/yoga, playing ukulele again, and getting a job after filing the immigration papers!
-> remember to do one thing at a time
-> break down into smaller chunks
-> plan ways to reduce stressful situations, not increase or worsen them

* Continue healthy eating / no binging
* Work on self-validation
* Work on healthier ways to deal with complicated grief
-> Monkey Man L’s death and guilt about death
-> hearing loss

* Ask about/look into other methods such as IFS (Internal Family Systems) and Schema Mode therapies.

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Past Problems

* Mother’s verbal and physical abuse (I really hate the way I wrote this one because, honestly, I feel closer to my mother than my father and I love them both very much, even when they piss me off. And my mom’s changed for the better after getting help herself.)

* Dad’s continued invalidation and overbearing tendencies (not to mention the fact that I still have to depend on him financially)

* Medical Trauma (e.g. still need to deal with jaw incident and set up a date for surgery, continued nerve pain, decreased bone density, past accidents that led to ER, prolonged stays at hospital during childhood; loads of surgeries)

* Sexuality and validation issues (e.g. what happened with Dusty and Emily)

*Repetetive compulsion with alcohol and drugs (mainly alcohol and self-harm)

Yep, so that’s what I have so far. We went over this list I wrote, which she said was very good. I think it’s a good starting point too. And since I was able to writeit out, it helped when she asked to explain what I meant by “sexuality and validation issues”. That’s when I brought up Sir Dusty and a lot of other things I may or may not mention here. Man, it was hard work!

Goals for therapy? That’s very mature of you. My goal was always to make it through the session without weeping, and I usually managed it. Except the time she described me “curled up in the foetal position, crying” which I can’t even recall. I think personally I’m a bit allergic to counselling, though I have to say the 2.5 years I did of psychodynamic counselling did help. It’s way better than person-centred ;-)!

I’m more of a weep after the session is over (once I’m in a fetal position in my room) type. Glad it’s helped you. I have a lot more faith in psychotherapy be it DBT or CBT or whatnot that psychotropic medication.

Been in and out of therapy since 2008, so I think I’m starting to get a little seasoned and smart about it. hehe. Also, I don’t think it works unless you want it to. You know, like an “alcoholic” can’t get better until he/she admits a problem in the first place.

I can relate to your ambivalence about your mom. I would say there was more negativity with my dad when I was growing up, but I am closer to him now than I am to my mom. Actually, maybe they were equally negative, but I was more hurt by my dad for some reason. But they’ve both grown as people since then. What your dad said sounds like something mine would say, too.

I’m ambivalent about almost everything in my life. heheh. But yes, especially with my mom. She was always so loving to me but then again she started boxing matches with me. Shit like that can confuse a child. My dad is just passive aggressive, and lately I don’t know if I’m just more irritable or what, but I get soooo annoyed at those negative/off-handed comments. I’m not the only one who says that. My mom and bro agree. The thing is, my mom actually admits to her flaws. He doesn’t. And that frustrates me even more. I’m glad your folks have grown. My dad is about to turn 70 and I think he’s just fed up that he can’t retire when he wanted to… you know, he’s getting old and cranky. But he’s such a preacher! BLAGH. heheh I’ll shut up now.